Promeds Pharmacy Group, Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

PROMEDS PHARMACY GROUP, INC.

Practice address

4068 Broadway
New York, NY 10032-1512

Phone

(212) 540-4068

Fax

(212) 540-4069

NPI assigned

Sep 19, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ilya LevyNPI 1467820050

Title

President

Phone

(212) 540-4068

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY3 enrollments

Enrollment records 3

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ilya Levy

  • Pharmacist
  • Bronx, NY
  • NPI 1467820050
  NPD Authorized official
• Joeun Lee

  • Pharmacist
  • New York, NY
  • NPI 1932971041
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1695081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712534400000",
    "number": "1619755840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4068 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100321512",
            "telephone_number": "212-540-4068",
            "fax_number": "212-540-4069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4068 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100321512",
            "telephone_number": "212-540-4068",
            "fax_number": "212-540-4069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROMEDS PHARMACY GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-19",
        "last_updated": "2024-04-08",
        "certification_date": "2024-04-08",
        "status": "A",
        "authorized_official_last_name": "LEVY",
        "authorized_official_first_name": "ILYA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "212-540-4068"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alla Prokhovnik-Raphique, PH.D.
• Michelle Ester Prokofiev
• Anthony Joseph Proli II, PHARMD
• Prolific Care Health Enterprises LLC
• Paul Promadhattvedi, M.D.
• Promenade Medical Care PC
• Promobility Physical Therapy, P.C.
• Prompt Care Inc
• Prompt Medical Care of Ny PC
• Kendall Frederick Pron, LMSW

• Community/Retail Pharmacy in New York, NY
• Providers in New York, NY by specialty
• Community/Retail Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.